Drug-eluting Bead-Transcatheter Arterial Chemoembolization for Advanced Hepatocellular Carcinoma Refractory to Conventional Lipiodol-based Transcatheter Arterial Chemoembolization

J Hepatocell Carcinoma. 2020 Oct 14:7:181-189. doi: 10.2147/JHC.S273929. eCollection 2020.

Abstract

Purpose: To evaluate the potential of drug-eluting bead (DEB)-transcatheter arterial chemoembolization (TACE) as a treatment option for patients with refractory to conventional lipiodol-based TACE (c-TACE) especially with decreased liver function.

Patients and methods: We retrospectively evaluated the treatment results of DEB-TACE for 89 HCC nodules in 27 patients with c-TACE refractory according to liver function.

Results: Although overall survival was significantly better in Child-Pugh A patients than in Child-Pugh B patients (median survival time, MST: 561 vs 347 days, p=0.031), progression-free survival was almost similar in both patients between Child-Pugh A and B (MST: 79 vs 87 days, p=0.534). Regarding antitumor response, the objective response rate (ORR) and disease-control rate (DCR) were 5.3/12.5% and 52.7/87.5% in Child-Pugh A/B, respectively. In each 89 HCC nodules, ORR and DCR were almost similar between Child-Pugh A and B (ORR, 20.3 vs 13.3%; DCR, 77.0 vs 73.3%, respectively). Adverse events of DEB-TACE were well-tolerated, and liver function was reserved during DEB-TACE procedures.

Conclusion: DEB-TACE could be a therapeutic option for advanced HCC patients with c-TACE refractory and decreased liver function.

Keywords: TACE-refractory; drug-eluting bead; microsphere; post-embolization syndrome; tyrosine kinase inhibitor.